Imaging Survey Your VisitDate of Service MM slash DD slash YYYY Service Performed MRI CT Scan X-Ray How did you hear about us? Doctor Referral Friend Advertisement Website Other If other, please explain:Please Rate the Following StatementsThe staff was courteous. Strongly Agree Agree Uncertain Disagree Strongly Disagree I received clear information from the staff. Strongly Agree Agree Uncertain Disagree Strongly Disagree The staff was knowledgeable. Strongly Agree Agree Uncertain Disagree Strongly Disagree The facility was comfortable and clean. Strongly Agree Agree Uncertain Disagree Strongly Disagree My appointment date and time was reasonable and convenient to me. Strongly Agree Agree Uncertain Disagree Strongly Disagree I would recommend MEDRVA Imaging to a family member or friend. Strongly Agree Agree Uncertain Disagree Strongly Disagree Comments